Grave Clémence, Bonaldi Christophe, Carcaillon-Bentata Laure, Gabet Amélie, Halimi Jean-Michel, Tzourio Christophe, Béjot Yannick, Torres Marion J, Steg Philippe Gabriel, Durand Zaleski Isabelle, Blacher Jacques, Olié Valérie
Direction des maladies non transmissibles, Santé publique France, Saint-Maurice, France (C.G., A.G., M.J.T., V.O.).
Direction Appui, Traitements et Analyses de données, Santé publique France, Saint-Maurice, France (C.B.).
Hypertension. 2025 Feb;82(2):357-369. doi: 10.1161/HYPERTENSIONAHA.124.23760. Epub 2024 Dec 9.
Hypertension is the most common chronic disease and a major modifiable risk factor for cardio-cerebrovascular and renal diseases. This study estimated the national burden of hypertension, defined as systolic blood pressure ≥140 mm Hg, on morbidity and mortality in 2021 in France.
For all diseases causally associated with hypertension (cardiovascular diseases, chronic kidney diseases, and dementia), the number and proportion of cases attributable to hypertension in adults aged ≥35 years were estimated using population attributable fractions. Age- and sex-specific population attributable fractions were computed using the distribution of hypertension in the French population. These population attributable fractions were applied to nationwide statistics for mortality, hospitalizations, disease prevalence, years of life lost, years of life lived with disability, and disability-adjusted years of life.
The largest population attributable fractions were for ischemic heart disease and hemorrhagic stroke, with over 40% of cases attributable to hypertension. Overall, more than 385 000 patients were hospitalized due to hypertension, with 3.7 million hospitalizations and 6.2 million hospital days (all hospitalizations, including 3.4 million for chronic kidney disease) and including 390 000 overnight hospitalization. In 2021, more than 1.15 million individuals lived with ischemic heart disease attributable to hypertension, 1.26 million with chronic kidney diseases, and 358 033 with heart failure. Among 184 059 annual deaths from cardiovascular diseases, dementia, and chronic kidney diseases, 30% (55 280 deaths) were attributable to hypertension. Hypertension accounted for 8.5% of all deaths and 498 052 years of life lost.
In France, despite near-universal health coverage and free health care access, the burden attributable to hypertension remains high.
高血压是最常见的慢性病，也是心脑血管疾病和肾脏疾病的主要可改变风险因素。本研究估算了2021年法国高血压（定义为收缩压≥140毫米汞柱）对发病率和死亡率的全国负担。
对于所有与高血压有因果关联的疾病（心血管疾病、慢性肾病和痴呆症），使用人群归因分数估算≥35岁成年人中可归因于高血压的病例数和比例。使用法国人群中高血压的分布情况计算年龄和性别特异性人群归因分数。将这些人群归因分数应用于全国范围内的死亡率、住院率、疾病患病率、寿命损失年数、失能生存年数和伤残调整生命年数的统计数据。
人群归因分数最高的是缺血性心脏病和出血性中风，超过40%的病例可归因于高血压。总体而言，超过38.5万名患者因高血压住院，住院370万次，住院天数达620万天（所有住院，包括慢性肾病的340万次），其中包括39万次过夜住院。2021年，超过115万人患有归因于高血压的缺血性心脏病，126万人患有慢性肾病，358033人患有心力衰竭。在每年184059例死于心血管疾病、痴呆症和慢性肾病的病例中，30%（55280例死亡）可归因于高血压。高血压占所有死亡人数的8.5%，导致498052年的寿命损失。
在法国，尽管医疗覆盖范围几乎普及且可免费获得医疗服务，但高血压造成的负担仍然很高。
